Provider Demographics
NPI:1952007841
Name:DEMOULIN FAMILY CHIROPRACTIC, LTD.
Entity Type:Organization
Organization Name:DEMOULIN FAMILY CHIROPRACTIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMOULIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-269-9435
Mailing Address - Street 1:4207 E MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-9304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4207 E MARGARET DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-9304
Practice Address - Country:US
Practice Address - Phone:630-269-9435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEMOULIN FAMILY CHIROPRACTIC, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization